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No Lab Tests


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Old 01-04-2017, 12:17 PM   #1
momof6300
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No Lab Tests

I have been having regular lab work done twice a year for as long as I can remember, both from my primary care doc and my rheumatologist. I received an order for bloodwork for my next primary care appointment and the only thing he is checking is my glucose. No thyroid tests (I have hashimotos too), no cmp, nothing. I am also on cholesterol meds and he wasn't even checking my cholesterol or liver function. I called his office thinking it was a mistake and they told me all he wanted was the glucose test (glucose or blood sugar was never mentioned at my last appointment). Then, I called my rheumy to see if he wanted any tests because I am going there in February and I wanted to get everything done at once. He said no tests were necessary and wanted to be copied on the tests from my primary. Now, I am not a big fan of blood work, but it just seems to odd to me that they both would cut out tests that I have been getting regularly for years. I am just wondering if they are cutting back on these tests for a reason related to health care? I read somewhere, and naturally I can't find the article now, that insurance companies are giving "bonuses" to doctors who have a low " average" of reimbursements, and that lab tests, mri's etc. fall in the reimbursement category. I am hoping this isn't true. Has anyone else experienced this?

 
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Old 01-05-2017, 04:37 AM   #2
VeeJ
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Re: No Lab Tests

Good morning. I was so curious that yesterday I asked 2 people who take statins & Synthroid what their doctors do (each have endocrinologist and PCP). Their doctors test at the lesser frequency you were just changed to. My sis added that most insurers have added "lab sharing requirements", which makes sense from a cost control standpoint. The other woman who takes a statin said her liver values are checked once yearly; and that although statins can raise liver values, those liver values can actually go up to 3x normal range before they become dangerous, therefore testing more often isn't cost-effective (that's per her doctor, and she was a nurse herself before retiring). As for lipid panel: once yearly for her.

Re rheum labs. I see my rheum every 4 months and have full labs every other visit, which makes sense for me because once I started Plaquenil & carefully avoiding sun, I became "subacute". I still have pain & fatigue but not blood abnormalities, so the interval he uses does suit my case.

But I'm cynical, too, so I appreciate your question. Here's a corker. This fall I needed an out-patient procedure, and I couldn't believe what my insurance paid out. The surgeon & anesthesiologist (they who did the REAL work) were discounted heavily & paid very modestly, while the big winner was the lousy hospital where I had prep-op tests, including a treadmill, that imo I didn't even need. It made me very angry to see how my PCP had over-ordered tests at "her" hospital (did she get bonus points for that?). When I protested, her response was that she'd NOT approve my procedure if I didn't do the tests. And because she'd waited until zero hour to call for the tests, she'd neatly painted me into a corner.

Another insurance oddity I've noticed: the huge differential between what my specialty lab bills for AI bloodwork & urinalysis vs. how much my insurance reimburses. It's huge, several thousand each time. Does the lab then claim the differential as a TAX LOSS? (I'd love to know the answer to this one.)

Anyhow... how are you doing lupus-wise? Well, I hope!

 
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